What is the ASQ-3?
The ASQ-3™ (agesandstages.com) is a questionnaire-based developmental screening tool designed and developed in the USA for use by early childhood educators and health care professionals. It is widely used in many countries and is highly valid, reliable and accurate.
It can be parent-completed or used as part of an in-person or phone interview. It relies on parents and caregivers as experts and enables developmental delays to be captured early while also highlighting strengths.
“The validity of [the] ASQ-3 has been studied more than any other screener. Psychometric studies based on a normative sample of more than 18,000 questionnaires show high reliability, internal consistency, sensitivity, and specificity. From ‘How reliable? We’ll let the data tell the story.’)
How did we develop the ASQ-TRAK?
Language and context have always been barriers to adopting mainstream practice in Aboriginal communities – but with modifications, we found we could use the ASQ-3 questionnaires as the base for building a more culturally appropriate version of the tool for Australian Aboriginal children.
We selected and carefully studied seven questionnaires from the ASQ-3 for adaptation, in collaboration with Aboriginal community members, cultural and linguistic experts, remote health practitioners and early childhood development experts in the Northern Territory.
Findings of the study informed the development of the ASQ-TRAK. For more information see our publication Adaptation of the Ages and Stages Questionnaire for Remote Aboriginal Australia on our Research page.
What’s the difference between the ASQ-3 and the ASQ-TRAK?
The ASQ-3 consists of 21 questionnaires developed to measure children from 1 month to 5½ years. It is designed to be parent-administered or administered by interview.
Each questionnaire has 30 items grouped into five areas: communication, gross motor, fine motor, problem solving, and personal–social. They also include general health questions. For full details, visit www.agesandstages.com.
The ASQ-TRAK is based on seven of the 21 ASQ-3 questionnaires. A number of modifications were made. The ASQ-TRAK:
- is shorter, having excluded the general questions.
- is written in plain English.
- includes an explanation of the overall questionnaire and of each domain.
- has illustrations for every item.
- has colour-illustrated flip charts to support caregiver engagement and administration by interview.
- has items that have been modified to be more culturally appropriate and draw on materials that are available in remote communities.
- is designed to be administered by interview rather than caregivers self-completing a questionnaire. This encourages the caregiver and child to demonstrate each item.
The screening ages – 2 months, 6 months, 12 months, 18 months, 24 months, 36 months and 48 months – align with routine ‘well-child checks’ undertaken in the Northern Territory (where the ASQ-TRAK was developed), which require developmental screening as part of the check.
The ASQ-TRAK kit includes a flip chart with colour illustrations for each of the seven questionnaires, for parents or caregivers to view during the ASQ-TRAK interview. This has been found to be a very valuable modification that acts to engage parents and caregivers in the process.
The ASQ-TRAK was translated into the local Aboriginal languages in regions where the adaptation took place.
Who can use the ASQ-TRAK?
The ASQ-TRAK is designed to be used in all settings in which the ASQ-3 can be used. It can be used by:
- health professionals, including Aboriginal Health Practitioners, Remote Area Nurses, Child Health Nurses, GPs, Paediatricians or Allied Health Specialists;
- early childhood educators, including in Families as First Teachers programs.
It is not designed to be self-administered by parents and families, although they are encouraged to be actively involved in the interviews.
What languages are available?
The ASQ-TRAK is available in the following languages:
- modified English;
- two Yolngu Matha languages (Dhuwaya, the language of instruction at Yirrkala school, and Djambarrpuyngu);
- Western Arrarnta.
What is the cost of the ASQ-TRAK?
Th ASQ-TRAK developmental screening tool is sold by the Royal Children's Hospital Shop. Prices of the ASQ-TRAK and the ASQ-TRAK Toy Kit can be found at the RCH Shop.
Where is the ASQ-TRAK being used?
The ASQ-TRAK is being used in health services and education settings across Australia.
An example of implementation in early education
The Northern Territory Department of Education has chosen the ASQ-TRAK as the most appropriate developmental screening tool for Aboriginal children in their Families as First Teachers (FaFT) program. Following a successful trial in four remote communities — Alekerange, Numbulwar, Yirrkala and Maningrida — the Department of Education has implemented the ASQ-TRAK in all FaFT sites in the Northern Territory.
"Information obtained from developmental screening will improve our understanding of children’s development and inform program planning - enabling targeted learning activities to be developed for individual children. The process of doing ASQ-TRAK is fun and very engaging, involving parents in their child’s ongoing development."
Ms Regina Thompson, Director, Families as First Teachers program
An example of implementation in health
The ASQ-TRAK was trialled in urban, rural and remote sites by South Australia Health’s Child and Family Health Service (CaFHS). It is now used with Aboriginal children and caregivers in all CaFHS sites and also by the CaFHS nurses providing a visiting service to the Anangu Pitjantjatjara Yankunytjatjara (APY) lands. Aboriginal Cultural Consultants, Child Health Nurses and Early Childhood Intervention Coordinators deliver the screen alongside caregivers and their children.
Are you adapting the remaining ASQ-3 questionnaires?
Research conducted in 2019 led to the modification and illustration of all ASQ-3 items for use with Aboriginal children. This will allow us to develop the remaining 14 age intervals (4, 8, 9, 10, 14, 16, 20, 22, 27, 30, 33, 42, 54 and 60 month questionnaires) from the ASQ-3™, increasing the suite of ASQ-TRAK questionnaires to 21. This will extend the range of developmental monitoring using the ASQ-TRAK to include children between the ages of one month to 5 ½ years.
The additional age intervals are not yet available however we are working on changing this as soon as possible. Once this work is completed we will inform all our website subscribers.